Good Doctors and the State of Missouri: A Connection Worth Remembering

As a full-time medical educator for more than half a century, I have learned that good doctors have certain defining qualities—a love for the medical profession, a passionate quest for knowledge, the constant pursuit of excellence, high regard for honesty, hard work, humility, and putting patients first, always.

In spite of their obvious values, these qualities receive only lip service—if that—during medical school and postgraduate training. Moreover, another crucial quality of good doctors—skepticism—gets even less attention. In fact, medical schools and postgraduate training programs actually stifle skeptical attitudes among trainees.¹

I find, for example, that medical students, house officers, and fellows often mindlessly embrace whatever their instructors or consultants tell them, whatever they read in a textbook or medical journal, or whatever a report says about an image study or investigative procedure. Rarely do these trainees realize that another instructor or consultant, another textbook or medical journal, or another interpreter of the image study or investigative procedure might—and frequently do—put an entirely different spin on the subject.² Questioning the veracity of the information they obtain is foreign to their mindset. They generally believe—erroneously—that individuals senior to them in medicine, especially authority figures, know more about a particular medical topic than they do. As a result, most of them never fully understand or appreciate the fact that the wise use of skepticism can greatly increase their medical knowledge, enrich their decision-making, and improve their patient care.

Throughout history, many luminaries have trumpeted skepticism. Witness the following examples:

If anyone declares to you that he has actual proof, from his own experience, of something . . . even though he is considered a man of great authority, truthfulness, earnest words, and morality, yet . . . you should hesitate.¹

— Maimonides (1135–1204)

Let every eye negotiate for itself and trust no agent.³

— William Shakespeare (1564–1616)

If doctors regularly followed Shakespeare's advice, it would disrupt the herd mentality that pervades our profession.⁴

The natural course of the human mind is certainly from credulity to skepticism.¹

— Thomas Jefferson (1743–1826)

Skepticism is the highest of duties, blind faith the one unpardonable sin.⁵

— Thomas Henry Huxley (1825–1895)

To my mind, science owes its success to doubting all things. . . . Too many physicians are willing to ride with the tide, to follow the flood of undigested literature, and to be carried away by the claims of the uncritical.⁶

— Maxwell Myer Wintrobe (1901–1986)

So what's the connection between good doctors and the “Show Me” state? Skepticism!